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General NPI Number Information
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NPI Number | 1306816012
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Entity Type | Individual
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Provider Name | JEFFREY DAVID HUTCHESON DMD
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Gender | Male
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Dates
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Enumeration Date | 01/25/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 8430 UNIVERSITY EXEC PARK DR SUITE 600
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City | CHARLOTTE
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State | NC
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Zip | 28262-3379
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Country | US
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Telephone | 704-548-1100
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Fax | 704-549-1455
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Provider Business Mailing Address
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Address Line | 8430 UNIVERSITY EXEC PARK DR SUITE 600
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City | CHARLOTTE
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State | NC
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Zip | 28262-3379
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Country | US
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Telephone | 704-548-1100
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Fax | 704-549-1455
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 6144
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 4385
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License Number State | AL
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